Differences between Types of Child and Adolescent Psychiatric Evaluations

Office Evaluation

done in psychiatric office

Initiated by: usually parent

Psychiatrist role: to evaluate and treat personnel

School Evaluation

initiated by: teacher - usually because of disruptive behavior

parent consent obtained

Psychiatrist role: make recommendations to school

most Ritalin is prescribed by primary care physician

Court Evaluation

Initiated by: court

May be mandated

Psychiatrist role:

Child and guardians waive confidentiality so report shared with the court

Adult Court - justice and punishment

Child Court - intervention and correction

Hospital Evaluation

Initiated by: pediatrician or intern/surgeon

Parental consent obtained by medical team and charted

Psychiatrist role: evaluate child and make recommendations to the medical team

Focus often on child’s response to a medical illness

Confidentiality and Informed Consent

confidentiality is the clinician’s obligation to hold in confidence information obtained from the patient in the course of their professional relationship

legal guardians/parents may access child’s psychiatric files

confidentiality also waved when evaluation is performed for the court (as stated above)

informed consent requires the patient understand the nature of their condition, risks and benefits of the proposed treatment, risks and benefits of alternative treatments, and the likely consequences if the patient remains untreated

exceptions to informed consent: emergency situations, children who are unable to understand their need for treatment